ccsp patient navigation work - ucdenver.edu patient navigation work ... to knock colon cancer out of...
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CCSP Patient Navigation Work Kirstin Le Grice, MPH
CCSP Patient Navigation Coordinator
What is CCSP?
The Colorado Colorectal Screening Program (CCSP) is a statewide patient navigation and technical assistance program that partners with safety net hospitals and clinics to offer no-cost patient navigation services for colorectal cancer screening to the medically underserved in Colorado. The program is funded by CCPD and housed at the University of Colorado Cancer Center.
• Goals:
• Improve colorectal cancer screening rates in Colorado
• Help CO reach the NCCRT screening goal of 80% by 2018
• How are we doing?
• Since inception, CCSP patient navigators have navigated almost
25,000 people through endoscopic screening!
Why is Patient Navigation Important?
The patient encounter is crucial
Eliminates barriers to care
Improves bowel prep outcomes
Provides individual assistance across cancer care continuum of care
Increases patient follow through with screening appointments
Decreases patient anxiety
Improves patient satisfaction and experience with health care system
Colorectal Cancer Screening Rates in Mesa County
Let’s Talk About Getting People
Engaged
In Reach
Targeting current clinic patients who are in need of CRC screening
Identify eligible clinic patients EMR Queries Chart reviews Ticklers in EHR Connection with other programs that share same
general eligibility criteria Help ensure that clinicians speak about
Spread awareness at your clinic Display posters Display and provide brochures
Educate your clinic patients Targeted mailings: post cards or letters from clinic
physicians Targeted phone calls
Resource Spotlight
Resources Include:Videos & Brochures to display lobbies and waiting rooms
Pins…Bracelets…T-Shirts…Mugs…
ApproachChampioning prevention, funding cutting-edge research & providing high quality patient support services
ObjectiveTo knock colon cancer out of the top three cancer killers
ApproachProviding industry-standard, production-ready files for print, web and interactive applications
ObjectiveHelping clinics create customized & targeted health information for the specific populations they serve
Products Include:Posters…Flyers…Inserts…Question Cards…Post Cards…Website Banners &
Badges
Outreach
Raising awareness throughout your community about the importance of CRC screening
Where does outreach happen?
At Health Fairs
At Social Events
Through Mailings
In Posters
In Brochures
On the Radio
Educate the Community at Clinic Patients on…
Importance of screening
Risk level
Family History & Genetic Syndromes
Screening Modalities
Screening Intervals
Importance of Health Lifestyle
Anatomy
More on Anatomy…
Cecum
Communication is Key!
Communicate with the patient and the care team
Develop a rapport and establish trust with patient
Ensure you have a strong capability statement
Define expectations and boundaries
Devise follow up strategies that work with the patient
When to contact (day, time)
How to contact (landline, cell, email, mail)
Reducing Barriers to Care
Facilitates patient access and utilization of care
Assists with patient and provider interaction
Helps ensure that patients find and access the services they need
Increases patient self-efficacy
Reducing Barriers to Care
CCSP Can Help!
Reducing Barriers to Care
CCSP Barrier Reduction Funds
Each fiscal year CCSP sets aside a certain amount of money to help patient navigators with the cost of certain barrier reduction methods like…
Reducing Barriers to Care
Hotel rooms for patients
Interpretation and Translation Assistance
Transportation Assistance
Bowel Prep
Child Care
Elder Care
CCSP Barrier Reduction Funds
Clinics can submit a request to CCSP’s Finance Manager via e-mail
New in FY2018 Clinics receiving barrier reduction funds must
submit receipts to CCSP
Reminders
Reminder Calls 1-3 days beforecolonoscopy
Making sure patients have transportation to and from the screening and supportive care after
Work with your patients to overcome common barriers
Remind patients of proper prep procedure
These reminder systems are evidence-based and have shown to improve CRC screening rates
Good Bowel Prep
= Good
Navigation!
Patients must complete a bowel prep – and complete it well – in order for the physician to fully visualize the colon and find any abnormalities and/or polyps
Prep Instructions: One Week before Procedure
Patient navigator places reminder call to patient to make sure they:
Are following physician instructions for blood-thinner medications such as Coumadin and Heparin
Have power prep solution at home
Have read through the bowel prep instructions
Prep Instructions: Two Days before Procedure
Drink plenty of water
Eat lightly
Avoid bulky, fibrous foods such as: Raw veggies, beans, peas, lentils
Wheat bran cereals and breads
Sweets
Fatty meats
Bottom Line:
The day before your colonoscopy, EVERYTHINGin the colon must come out.
Prep Instructions: Day Before Procedure
Follow a clear liquid diet
Water
Clear broth
Clear fruit juice
Coffee or tea – no cream!
Plain gelatin
Popsicles
Soda
Sports drinks
Do NOT drink red, blue, or purple liquids
A Few Tips…
Have someone do the cooking so you don’t have to while you’re taking the prep. That’s just mean!
Avoid having guests over while you prep.
Ask for some alone time. Have the kids spend the day at a friend’s house. Ask your husband or wife for privacy.
Make Sure to Have…
Have a book handy. You’ll be spending your day on the porcelain throne so you might as well have some company!
The softest toilet paper money can buy.
Baby wipes. Yes, you read that right
Diaper rash cream. You’ll thank us.
Try Your Prep…
After putting it in the freezer for 2 hours
With a straw
With Gatorade
With Crystal Lite Powder
With Sprite or 7-Up
Sample Prep Diet…
Breakfast
1 glass pulp-free juice
1 bowl Jell-O
1 cup coffee or tea
Snack
1 glass pulp-free juice
1 bowl Jell-O
1 popsicle
Lunch
1 glass pulp-free juice
1 glass water
1 cup broth
1 bowl Jell-O
Snack
1 popsicle
1 cup coffee or tea
Dinner
1 cup pulp-free juice
1 cup broth
1 bowl Jell-O
16oz. Water
Care Coordination
Assist with appointment setting
Ensure F/U of colorectal screening results regardless if abnormal or normal
Patient navigators are the liaison between patients and providers
F/U with patients about results of procedure Be sure they understand the results and when they
should be re-screening
Provide treatment navigation or facilitate transfer of care for treatment services
Be sure to know who does what!
CCSP Reporting Activities
Collection of data points for evaluation outcomes and navigation services
Rates of
No show
Appropriate prep
Complete follow-up
Provide CCSP regular verification of HB 06-1023 Certification for Payment Request for payment of services
Maintain files with patient specific data and records for fiscal and evaluation audits
Questions?
Evaluation and Policy for ReimbursementKirstin Le Grice
CCSP Patient Navigation Coordinator
Let’s Talk About…
Why we evaluate
What we evaluate
The Aggregate Data Collection Tool & Reporting in Survey Monkey
Reimbursement for Screens
Documents Needed
Why Do We Evaluate?
We want to know if CCSP is preventing CRC & saving lives!
Reaching screening goals? Screening population characteristics:
AgeEthnicityGender LocationAsymptomatic
Are we reducing barriers for our patients?Navigation, transportation, translation services
Demonstrate PN effectiveness in screening Internal & external reporting
Why Do We Evaluate?
Evaluation of the program is done by collecting and analyzing data from different sources based on the outcome of interest.
Data sources include: Survey Monkey
Reports from clinics (phone, paper, email, billing…)
Patient & Provider Satisfaction Surveys
Clinic/file audits
Aggregate Data Collection Tool
Because PNs report aggregate – or cumulative – data we no longer need to use consent forms. Yay!
Data is submitted via Survey Monkey once a month
CCSP has created a data tracking sheet for PNs to use at their clinics.
You may also use a different tracking method –whatever is easiest for you, but you will be responsible for specific data points in the even of an audit
What Data Elements Do I Need?
This is what we are asking you to report on a monthly basis.
A simple count of clients into each category.
That’s it!
Where Do I Find the Right Data?
Demographics Screening intake (referral) form, EMR & patient
interview
Clinical outcomes Endoscopy Report: verify age, fam history,
symptom status, prep quality, cecum reached
Pathology Report: pathology result (adenomas? cancer?)
Submitting The Data
When is our data due? By the 10th of the following month.
That should allow time to receive & review endoscopy or pathology reports for clients screened at the end of the month.
August data is due September 10th
What if we need to update our numbers from the previous month?
Contact Evaluation Coordinator to update numbers once submitted.
Can anyone enter the data? We ask that you have one central person responsible for
entering data for your clinic.
If more than one person is navigating and receiving reports it is up to you to figure out how to best manage your tracking responsibilities.
Getting Reimbursed
In order to receive this reimbursement, clinics must submit two things to the program’s finance manager:
Certification of Verification: This document certifies that the patients navigated are
lawfully present in the United States. Every patient submitted on this form must have an affidavit on file.
Billing Invoice This document indicates the number of patients for
which you are requesting reimbursement from the program
Clinics are asked to submit these forms on the 10th of every month
Affidavit
All CCSP eligible patients must have a signed affidavit on file at their clinic
In the event of an audit, CCSP will request patient Affidavits
Certification of Verification (COV)
CERTIFICATION OF VERIFICATION UNDER CRS 24-76.5-103
We, hereby certify that pursuant to CRS 24-76.5-103
have verified that the patients eighteen years of age or older who we are referring for health
services to be funded by state appropriated funds (a) have provided appropriate identification
(b) have executed the required affidavit, and (c) are lawfully present in the United States,
and we are able to supply evidence of the above if so requested by you or any agency of the State
of Colorado.
Signature:
Date:
Print Name:
Signature
Patient Encounter ID# Patient Encounter ID#
LEAVE BLANK LEAVE BLANK
Screening Service Provider(s):
Month/Year Service Provided:
Number of Patients Certified:
Billing Invoice Form
Provider: CHC:ABC Clinic, Inc ABC Clinic, Inc123 Smith StreetAnytown, CO
Invoice #
Services Provided: Patient Navigation Terms: Due Upon Receipt
Dates of Services Provided (mm/dd/yy)From: To:
Date Submitted:
Prepared by:
Quantity Description of Services Rate Amount Due
Patient Navigation $90.00 $ -
$ -
$ -
Total Amount Due $ -
Please attach a Certification of Verification for all CCSP and Insured Patients.
Contact Information
For questions regarding evaluation, data collection, or Survey Monkey, please contact:
Shannon Pray
Evaluation Coordinator
303-724-3540
For questions regarding billing and reimbursement, please contact:
Lori Workman
Finance Manager
303-724-1296